Malaria

Malaria Plasmodium Management Antimalarials Resistance KEY POINTSIntravenous artesunate for severe malaria and oral artemisinin-based combination therapies for uncomplicated malaria are first-line treatment for all Plasmodium species causing disease in humans.Species-specific diagnosis is important to guide appropriate primaquine administration for gametocytocidal treatment of falciparum malaria to reduce transmission in endemic areas, and for radical treatment of vivax and ovale malaria to prevent relapse.Severe malaria management requires early renal replacement therapy for acute kidney failure and cautious fluid resuscitation to prevent lethal pulmonary edema.Post-artesunate delayed-onset hemolysis of once-infected red blood cells is an expected consequence of the removal of pyknotic ring form parasites through splenic pitting after artesunate treatment.Artemisinin and partner drug resistant falciparum malaria is spreading in the Greater Mekong Subregion, and increasingly causes treatment failure of artemisinin-based combination therapies.